The management of metacarpal and phalangeal fractures of hand by K-wires and Joshi’s external stabilization system

Abstract

Background: Hand injuries are quite common and affect 15% of people who go to the emergency room. The metacarpals and phalanges are the two bones that fracture most frequently, with a prevalence of between 10 and 15%. Use of K-wires with an external fixation system, such as Joshi's external stabilization system (JESS), is optional. According to the ligamentotaxis theory, JESS functions. Aim was to evaluate the clinical and radiological outcome of metacarpal and phalangeal fractures using k wires and jess. Methods: This prospective study was conducted in post graduate department of orthopaedics SKIMS medical college Bemina, on 40 patients with metacarpal and phalangeal fractures managed by Kirschner wires (K-wires) and JESS. The collected data was analyzed with the help of statistical package for social science (SPSS), version 21 Results: In present study the most of the study subjects were in the age group of 28-37 years (40%), there was male predominance with the male to female ratio 2.5:1, majority of the study subjects were labourer (38%), right side was involved most commonly (62%), the major cause of fracture was road traffic accident (58%) and most (96%) of the study subjects were operated within 24 hours of the injury. Conclusions: The study concluded that augmentation of JESS over K-wires provides a stable skeletal environment with early tissue healing and immediate active and passive mobilization of the uninjured adjacent joints and also provides rotational stability as the majority of the study subjects achieved excellent functional outcome.